Cervical health · Şişli, Istanbul
Understand your HPV and Pap smear results.
Dr Alparslan Demir
Specialist in Obstetrics and Gynaecology
Appointment enquiries on WhatsApp
A positive HPV test or an abnormal Pap smear is not, on its own, a diagnosis of cancer. Your reports and medical history guide whether colposcopy or follow-up is needed.
Source: NCI · HPV and cancer
HPV and colposcopy: quick answers
If one question keeps going round in your mind as you read the report, let us start there. I try to understand that concern before moving into the technical detail of the tests.
What does a positive HPV test mean?
HPV was detected in the sample; this result alone is not a diagnosis of cancer.
Read about interpreting resultsIs colposcopy painful?
You may feel pressure, discomfort or brief pain, and you can ask to pause or stop the examination.
Read about comfort during the examinationHow long does colposcopy take?
The examination usually takes about 10–20 minutes; discussion and preparation add to the appointment time.
See an example appointment timelineDifferent tests, different questions
HPV testing, Pap smears and colposcopy
Seeing all three names in your paperwork can be confusing. I first explain which test was done, then what information that particular test can provide.
01 · The virus
HPV test
Checks a cervical sample for high-risk types of human papillomavirus. A positive result does not establish whether there are abnormal cells or cancer.
02 · The cells
Pap smear
Also called cervical cytology, this test examines cells collected from the cervix. It looks for cellular changes rather than testing for the virus itself.
03 · A closer look
Colposcopy
An examination of the cervix using light and magnification. If needed, a small tissue sample can be taken for laboratory assessment.
You do not necessarily need all three. Your age, symptoms and previous results help determine the appropriate test and follow-up interval.
Source: NCI · Cervical cancer screening
Making sense of your report
What happens after a positive or abnormal result?
I understand how the word “positive” can overshadow everything else on the page. I listen to your concern, then work through the date, HPV type and accompanying results with you.
The word “positive” does not tell the whole story. Your HPV type, cytology, previous tests and any history of cervical treatment are considered together.
Positive HPV, normal cytology
These results can occur together. HPV 16 or 18 generally warrants colposcopy even when cytology is normal. For other types, repeat testing or colposcopy depends on your individual risk.
An abnormal Pap smear
ASC-US, LSIL, ASC-H, HSIL and AGC describe different findings. Some can be monitored; others need further investigation. An abbreviation alone cannot determine your treatment plan.
Source: CDC · Cervical screening and follow-up
Source: NCI · Symptoms
Your doctor
Dr Alparslan Demir
Please do not feel you should already understand the terminology. I use your report to explain the findings in a way we can follow together, and you can ask me to go over a term again.
Specialist in Obstetrics and Gynaecology
I completed my specialist training at Taksim Training and Research Hospital and have been seeing patients at my private practice in Şişli, Istanbul, since 2014.
My approach is to listen to your concerns, explain findings clearly and involve you in decisions. Your cervical health assessment and follow-up plan are based on your medical needs and personal circumstances.
Education and professional background (Turkish)Your consultation
Your report, your assessment, your next step
We start with what the report says, then identify which question remains unanswered. Only then do I move on to the follow-up plan, so you can ask why each proposed step is being considered.
Review your results
Discuss your current report, previous screening and the questions that matter most to you.
Understand the options
Discuss what an examination, repeat test or colposcopy could clarify, including the benefits and possible risks of any proposed procedure.
Clarify follow-up
Establish how results will be reviewed, when to return and which symptoms should prompt medical advice.
Your appointment, step by step
The times below illustrate a possible visit when colposcopy is planned. They are approximate, not a fixed appointment length or a promise of a same-day procedure. A consultation to review reports may not involve all of these stages.
Minutes 0–5
Your reports and questions
Review previous HPV, cytology and biopsy findings, symptoms and the questions you want to discuss.
Minutes 5–10
Explanation and consent
Discuss why an examination is proposed, the alternatives and possible discomfort, with time for questions.
Minutes 10–15
Preparation
Prepare in privacy and get comfortable on the examination couch. Let the clinician know about anxiety or discomfort.
Minutes 15–35
Colposcopy, if indicated
The cervix is examined; a biopsy is taken only when clinically indicated and with your consent. Not every colposcopy involves a biopsy or treatment.
Minutes 35–40
Initial findings and follow-up
Discuss what could be seen, any biopsy aftercare and how results will be reviewed. A pathology result is not available immediately.
Timing varies with the findings, questions, additional assessment and any breaks you need. Ask the practice how much time to allow for your visit.
About the examination
What happens during colposcopy?
If you are wondering whether the device goes inside your body or whether a biopsy will happen without warning, let us discuss that first. I explain the steps before asking which part feels uncomfortable or worrying to you.
Position, timing and what you may feel
You lie back on the examination couch with your knees bent and your legs supported, with privacy while you prepare. The examination itself usually takes about 10–20 minutes. The solutions may tingle or sting slightly; the speculum can cause pressure, and a biopsy may feel like a brief pinch or period-like cramp. You do not have to put up with pain silently: tell your clinician, and ask to pause or stop whenever you need to.
A speculum allows the cervix to be seen. The colposcope stays outside your body. Solutions help highlight areas for examination; a small biopsy may be taken if indicated.
You may feel pressure, and a biopsy can cause brief pain or cramping. Experiences vary. Tell your doctor about discomfort; you can ask to pause.
Source: NHS England · Having a colposcopy
Before your visit
Bring previous reports. Mention possible pregnancy, allergies and medicines. Do not stop blood thinners yourself. Ask about preparation if you have menstrual bleeding or use vaginal medication.
After a biopsy
Light spotting and cramps can occur. Follow instructions about sex, tampons and exercise. Seek medical advice for heavy bleeding, fever, offensive discharge or worsening pain.
Source: NHS · Colposcopy
What is compared at follow-up visits?
Where an earlier record is available, I use the images to show which area I am reviewing. We also separate visible changes from questions that an image alone cannot answer.
Images are recorded during colposcopy. Where comparable images are available at a later visit, the same area can be reviewed alongside its earlier appearance, including its location, borders and visible changes. Image comparison forms part of the follow-up record; it cannot provide a definitive diagnosis on its own or replace a biopsy when one is indicated.
These images contain personal health information. You can ask about the purpose of image recording during your consultation.
Biopsy findings
Understanding CIN 1, CIN 2 and CIN 3
I start by explaining what the number on the report means. We then discuss which other findings matter when considering follow-up or a procedure in your circumstances.
CIN describes abnormal changes in cervical tissue. A CIN grade is not a cancer stage.
- CIN 1: Low-grade changes, commonly managed with follow-up.
- CIN 2: Treatment or, in selected circumstances, close observation may be considered.
- CIN 3: High-grade precancerous changes, usually requiring treatment. CIN 3 is not cancer.
Pregnancy, previous treatment and future pregnancy plans can influence management. Your report needs individual interpretation.
Source: NCI · HPV and Pap test results
Does everyone need LEEP or a cone biopsy?
No. These procedures remove abnormal tissue when indicated. They do not guarantee a negative HPV test. The extent of treatment, bleeding risks and possible effects on future pregnancies should be discussed before a decision.
Source: RCOG · LLETZ
Common online claims: what the evidence means
Please mention information you have read online if it is troubling you. I first clarify the claim, then explain what has been established and what remains a promise rather than evidence.
“A herbal remedy can kill HPV.”
In context: There is no established herbal treatment proven to reliably eradicate HPV. A negative test after taking a product does not establish cause and effect; supplements should not replace recommended follow-up.
Source: CDC · HPV information
“Vaccination has treated my HPV, so I can stop screening.”
In context: HPV vaccination is preventive; it does not treat an existing infection or cellular changes. Screening and follow-up appropriate to your history remain important after vaccination.
Source: CDC · HPV vaccination
“My viral load has fallen, so colposcopy or biopsy is unnecessary.”
In context: A number alone cannot show whether cervical cells or tissue have changed. Follow-up still depends on HPV type, cytology, previous history and biopsy findings when needed.
Your questions
Questions we can talk through in your consultation
You do not need medical terminology to ask your question. “What does this mean for me?” is a useful place to start; I clarify the concern before explaining what the report shows.
Will I have HPV forever, or can it go away?
Most HPV infections are controlled by the immune system over time. A negative-test date cannot be predicted for an individual. Persistent high-risk infection needs appropriate follow-up.
I understand how tiring that uncertainty can be; I explain what we know now and what we hope to learn from the next review.
A single positive result cannot show how long the infection has been present. Follow-up considers whether the same high-risk type persists alongside any cellular changes.
Source: NCI · HPV and cancer
When did I get this? Does it mean my partner passed it to me recently?
No. HPV can remain undetected for years. A positive result is not proof of recent transmission or infidelity.
I recognise that this can raise relationship concerns too, so I separate what the report can tell us from what it cannot.
A previous negative test does not establish an exact date of infection either. The report should therefore not be used to draw conclusions about a partner or the timing of transmission.
Source: CDC · HPV information
My report says NILM but HPV positive. How can both be true?
No precancerous or malignant cellular changes were identified in the sample. NILM can occur with a positive HPV test; both results inform follow-up.
I put the two results side by side and explain that one assesses cells while the other detects the virus.
NILM describes the cell sample examined; it does not mean the HPV test is also negative. New symptoms such as bleeding still need assessment even after normal cytology.
Source: NCI · HPV and Pap test results
Does a positive result mean I definitely need colposcopy?
No. HPV type, cytology and previous results guide the decision. Repeat testing may be appropriate in some situations; others require colposcopy.
I first discuss which question colposcopy would help answer in your assessment.
A history of high-grade cervical changes or treatment for them can alter the follow-up plan. Another person’s screening result is not a reliable guide to your own review interval.
I have been sent for colposcopy. Does that mean I have cancer?
No. Colposcopy also helps clarify screening findings. A referral is not a cancer diagnosis; a biopsy, when needed, provides tissue information.
Hearing the name of a procedure can be worrying; I begin by explaining why it has been recommended.
The appearance at colposcopy and the pathology report provide different information. When a biopsy is needed, its findings are interpreted alongside cytology and HPV results.
Source: NCI · Cervical cancer screening
Could a medicine or supplement make the virus go away?
There is no established antiviral treatment that reliably eradicates HPV. Treatment addresses warts or abnormal cells when present. Supplements must not replace indicated follow-up or treatment.
Please tell me about any products you use; we can discuss what you hope they will do and what is being claimed for them.
A negative test after taking a product does not, on its own, show that the product caused the change; HPV may become controlled over time without it. Tell your clinician about any herbal products or supplements you use.
Source: CDC · HPV information
If I get vaccinated now, will it clear the HPV I already have?
No. Vaccines prevent infection; they do not treat existing HPV or cellular changes. Vaccination may still be discussed after a positive test, considering age and previous doses.
I keep the vaccination discussion separate from follow-up of the current result because their aims differ.
Vaccination may protect against some HPV types you have not yet encountered, but it does not cover every type. Continue the cervical screening and follow-up recommended for you after vaccination.
Source: NCI · HPV and cancer
Source: CDC · HPV vaccination
I have HPV. Do I have to put my plans for a baby on hold?
Tell your doctor before assessment. Colposcopy can be performed when indicated in pregnancy; biopsy and treatment decisions require individual consideration. Discuss the possible pregnancy effects of cervical excisional treatment beforehand.
I would like to hear about your pregnancy plans early so that this concern is part of the assessment.
HPV positivity alone does not necessarily mean pregnancy must be postponed; accompanying cytology and biopsy findings matter. During pregnancy, examinations that are needed are considered separately from procedures that can wait until after birth.
Source: RCOG · LLETZ
My biopsy result is taking longer. Does that mean something is wrong?
Timing depends on the sample and laboratory assessment. Confirm how and when you will receive the result. Contact the practice if you have not heard by the agreed time.
I understand that waiting can be difficult, and I make a point of clarifying how you can follow up the result.
Further laboratory assessment can extend the reporting time; a delay alone does not indicate a serious finding. Agree how you will receive the result and who will discuss it with you.
I had my tests elsewhere. Can I bring those reports?
Bring your existing HPV, cytology, colposcopy and pathology reports to the consultation. Their dates and comparison with earlier results help inform the assessment.
I begin by putting the available reports in date order; we can read the older results together as well.
Bring the full report, including the HPV type, sample date and pathology description, rather than only a “positive” message. Whether a test needs repeating depends on the available information and clinical assessment.
How can I ask about consultation and procedure fees?
Contact the practice for appointment and fee information. Clarify whether the proposed visit includes consultation only or additional tests, biopsy and pathology assessment.
Not every visit requires biopsy, pathology or additional testing. Before deciding on a proposed procedure, ask why it is recommended and what the quoted fee includes.
Do I need screening if I feel well?
When discussing screening without symptoms, I begin with its purpose. I then check whether earlier findings mean you need a follow-up plan separate from routine screening.
Precancerous cervical changes may cause no symptoms. Screening and completing recommended follow-up are therefore important. Screening ages and intervals depend on national programmes and your history; follow-up after abnormal results differs from routine screening.
HPV vaccination and cervical screening complement each other. Vaccination does not replace screening.
Source: WHO · Cervical cancer prevention
Planning a visit to Istanbul
Before you make travel arrangements
Contact the practice to confirm appointment availability and language arrangements. Bring your original reports and ask in advance whether a translation is needed.
If a biopsy or further treatment is being considered, clarify result timing and follow-up before booking a return journey. Some care may require more than one appointment. Discuss how follow-up can continue with your usual clinician after you return home.
Şişli, Istanbul
Appointments and practice details
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For a consultation about your HPV or Pap smear result, a recommendation for colposcopy, or your cervical screening plan, contact the practice.
Appointment enquiries on WhatsApp
Address
19 Mayıs Mahallesi, Halaskargazi Caddesi No:226/1Çiftkurt Apartmanı, Floor 1, Apartment 1
Şişli / Istanbul, Türkiye
Before your appointment
Have your previous reports and medication list ready. Please confirm appointment arrangements and any proposed tests or procedures directly with the practice.
Medical content lead: Op. Dr. Alparslan Demir
Obstetrics and Gynecology Specialist. Specialist training: Taksim Training and Research Hospital. Following compulsory service in Şanlıurfa, he worked at Medicana International Istanbul and Avicenna Hospital. He has practised at his private office in Şişli since 2014. Education and professional background (Turkish).